Oh SNAP.
This is the latest safe-sleep ad campaign from the city officials of Milwaukee. You don’t need to be a rocket scientist to know that the blogsphere is going to blow up over this one. Although I do happen to BE a rocket scientist.
As a general rule I try to stay away from the co-sleeping yay or nay discussion mostly because I’m afraid that the pro-co-sleeping contingent will figure out where I live and then we will be forced to move. But to be clear, my official stance on co-sleeping is:
A) It’s OK if YOU’RE happy with it.
B) You’re willing to do it SAFELY.
As for the ad-campaign regardless of your opinion about it, you have to acknowledge that by any advertising measure it is immensely effective. It’s gone viral, it’s memorable, it’s thought-provoking, and it may just be shocking enough to get people to change their behavior (time will tell.)
But nobody is talking about its merits as a marketing tool because we’ll be so busy arguing about the anti-co-sleeping message.
But let’s put that aside for a second and reflect on some horrifying facts here.
Horrifying Stats About Milwaukee
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- The rate of SIDS in the US is less than 1 in 1,000. The infant mortality rate (which would include SIDS) in the US is 6.75 in 1,000.
- The rate of infant mortality in Milwaukee is 10.8 For white babies, it was 5.4. The rate for black babies was nearly three times as high: 14.1.
- Thus, if you give birth in Milwaukee your child is almost 60% more likely than average to not make it to their first birthday than the average American baby. If you’re black, that number jumps to 100%.
- 53.7% of Milwaukee babies who didn’t make it to their first birthday succumbed to complications due to prematurity.
- 19% of Milwaukee babies who didn’t make it to their first birthday fell to SIDS.
- The general American rate of SIDS relative to infant mortality is 6%.
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Thus a baby born in Milwaukee is over 3X more likely to succumb to SIDS than an average American baby.
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So before we get all high and mighty on our Pro Dr. Sears Attachment Parenting horses, take a minute to consider what a catastrophic problem Milwaukee families, healthcare providers, and government officials are facing. The stories and statistics of loss are staggering. And the experts THERE believe that unsafe bedsharing is a significant problem. This is not an advertisement for AMERICA, it’s for MILWAUKEE.
Clearly the much bigger problem in Milwaukee is premature birth which is linked to poverty and the unavailability of affordable prenatal care. This is a billion dollar problem that will take time and money to tackle (and I’m guessing Milwaukee has neither). So the city health officials are targeting the #2 contributor to infant mortality via making safer sleeping choices because it doesn’t cost the city scarce tax dollars. Does this make them villains or just practical?
Oh I know, there are going to be million posts published tomorrow decrying the ad-campaign and raising the “Yay Co-Sleeping” battle cry. And by coming out in support of this campaign I risk being ostracized by friends and neighbors alike (Vermont is mecca for attachment parenting types). But here is the ugly co-sleeping truth that nobody wants to cop to:
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- The American Academy of Pediatrics does not support co-sleeping. People like to barf all over them as though the AAP is a bunch of hippies who got lost on the way home from the latest Phish concert. I’m not suggesting that the APP is infallible, but when in doubt, why not give 60,000 pediatricians the benefit of the doubt?
- The strongest supporter in the medical community of co-sleeping has been James J. McKenna, PhD at Notre Dame. His book, Sleeping with Your Baby should be required reading for ANYBODY who is or plans to co-sleep.He talks at length about safe co-sleeping complete with pictures/diagrams.
- Smart, caring, well-informed families participate in UNSAFE CO-SLEEPING ALL THE TIME. I’ve seen it many MANY times. Don’t believe me? Check out this 2008 study from the Journal of Pediatrics that found that over 1/3 of parents who DID co-sleep were engaged in unsafe behavior while co-sleeping at 3 months.
- Still not convinced? OK more numbers. 20% of adult Americans smoke. So I hope they know they can’t safely co-sleep.
- 34% of Americans are obese. So they also can’t safely co-sleep.
- 9% of adults use illegal drugs and about 20% abuse prescription drugs. So they’re out.
- Some large percentage of people who use comforters, have dogs or other pets in their beds, or have older siblings who may crawl into bed with them, also can’t co-sleep. BTW – this is according to Dr. McKenna the maven of co-sleeping so don’t yell at me because your dog needs to go.
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So there are a whole bunch of people who right off the bat should never ever co-sleep. And my guess is that the people in Milwaukee who this ad campaign is targeting (due to high premature birth rates, drug use, alcohol abuse, etc.) are probably in large part people who should not be co-sleeping for exactly the reasons listed above. Also please note that the fine print suggests that you should call for help if you can’t afford a crib. Why? Because part of the problem in Milwaukee is that families can’t afford a crib and are putting their baby to sleep on the couch. And it ends badly.
Wouldn’t it be great if instead of this being about co-sleeping it raised awareness about the plight of underprivileged parents in poor cities? The desperate need for quality prenatal care? Wouldn’t it be great if maybe this led to increased Federal funding or even private donations to clinics and other worthy organizations? Yeah it would be. But it won’t.
But I bet their Ad Agency is going to win a bunch of awards for it. So there’s that.
{Photo Credit: TheGiantVermin }
Tiffany
November 16, 2011 at 8:32 amWow. Great post. When I first saw these pics I was horrified because they are so shocking. I thought, “Is that really necessary?” Your post has really changed my perspective.
Alexis
November 17, 2011 at 2:43 pmThanks Tiffany. I’m not a public policy expert or anything but I knew that most people would respond negatively to the ad (it is intentionally shocking) and I wanted to offer a different perspective on it. I guess time will tell if it makes a difference – positive or negative. Fingers crossed for Milwaukee.
WI Dad
November 16, 2011 at 1:38 pmGreat insight and logic! I jumped over here from comments on another blog. Glad I did!
Alexis
November 17, 2011 at 2:44 pmYeah I commented there too. I’m not trying to tell people their feelings aren’t valid. But that maybe there issue is more complex than it seems at first glance. Thanks for chiming in 🙂
Alicia
November 17, 2011 at 9:23 am“Vermont is mecca for attachment parenting types.” and presumably they are for co-sleeping. According to the Kaiser family foundation Vermont has a lower than national average rate of infant mortality.
http://www.statehealthfacts.org/profileind.jsp?rgn=47&cat=2&ind=48
One of the main reasons cited for co-sleeping is to calm a baby so everyone can sleep. Sleep is necessary for cognitive functioning. Have you checked out the news to see how many women are killing their babies for crying they can’t calm? Ads like this can add unreasonable fear and frustration to the mind of an overstressed and tired parent. I’m all for educating people and training them through public service announcements but this is unhelpful and threatening. TELL THEM that smoking, drinking, obesity are dangerous, that other sleepers do not belong in the bed! TELL THEM that the sheets have to be pulled tight and NO pillows or comforters, TELL THEM about co-sleeper beds (30.00 on craigslist)….hey, how about creating bigger ones for older children! And while we’re at it, lets admit that poverty is bad for kids and try to change it.
Alexis
November 17, 2011 at 2:59 pmActually I believe (but can’t confirm) that VT has the LOWEST infant mortality rate in the nation – WOOT WOOT!
I gave birth to two healthy full-term 10 lb babies here. I had affordable access to fantastic prenatal care. I took not one but THREE classes (birth, nursing, new baby care). Of course I could do this because I have ready access to a car/transportation. After I gave birth I had ongoing in-home visits from VNA, IBCLC, and postpartum doulas. This was on top of office visits with my OB, midwife, and pediatrician (all of whom also visited me in the hospital). I had wonderful home-made meals delivered to my home for weeks from local families. When my son was old enough we went to free Building Bright futures infant playgroups where trained facilitators were on hand to answer questions and help me connect to relevant local and state resources. If my husband was obese, using drugs, or drinking, he would respect my request to not sleep in the same bed with our infant son. Of course this request would not be a huge inconvenience for him because we have an available guest room with a queen sized bed in it.
I know our family is truly blessed to have had all this support and have access to these great resources. I’m also pretty confident that NONE of what I described above applies to the families in Milwaukee that this ad is targeting.
I understand your frustration and I knew when I posted this that I would be in the vast minority with my opinions. Maybe this ad is simply fear mongering and will have no positive effect. Or maybe it is shocking enough to elicit change in people who don’t have the same access to training and support that you and I do. Time will tell. But I know we are in agreement that we really all want more of those babies to have the chance to grow old.
oldmdgirl
March 5, 2012 at 2:22 pmThe <5 times brought my baby into bed with me when she was less than 1 month old were because she had fussed all night long, and my husband and I had gotten <4 hrs of sleep for several consecutive nights. I was terrified of doing it, which is why it only happened 5 times. However that bit about "educating the parents" in the discussion section really peeved me. None of the suggestions made by the pediatrician worked, she obviously could not relate (she had no children of her own), and finally they all basically told me to "get help" and "suck it up." My husband and I have no help. My parents are disabled and his live abroad. And he works 14 hours per day (including commute). We have no other relatives. I suppose we could have hired a night nurse, but neither of us were convinced it would have helped, and that is also a really expensive option.
So in sum: We co-slept out of desperation and the suggestions we received from our pediatricians were unhelpful at best. My husband and I are medical professionals (him – PhD, me – MD-PhD), and this was *still* a problem for us. The way to address this is more compassionate care from medical and public health officials that is based in the realities facing parents of newborns. Alicia is correct in stating that co-sleeping often happens out of desperation. More scolding isn't going to fix that; in fact it may make it worse.
I am guessing the SIDS rate is lowest for VT because it has few poor urban black people, rather than some public health victory. But that's just the epidemiologist talking.
Alexis
March 6, 2012 at 8:29 pmI’m so sorry to hear you had such a rough time of things. And I can totally relate to getting the “suck it up” feedback from doctors. Case in point – it took us over 5 months to diagnose my first son’s reflux because the medical community’s response to our increasing pleas that something was wrong was, “babies cry, suck it up.”
I don’t think expecting compassionate care and intervention from the medical community is likely to happen although it would be nice. I continue to hope that there would be more support from the postpartum nurses/doctors in the hospital on baby soothing, sleep, nursing, and postpartum depression. Hope springs eternal.
There are NO urban people in VT (seriously there is nothing even close to a city here) and you’re right in the fact that we don’t have a huge black population. But don’t think there isn’t a large underclass in VT who don’t have access to much support. It’s sort of a strange state – all of the money resides in a single county and the rest of the state is largely made up of low income rural households. However the truth is that in VT early intervention & family support services for kids 0-3 years are pretty spectacular. So yay VT!
Teresa
November 18, 2011 at 2:16 pmI actually appreciate your take on this. I don’t get into the middle of that argument myself, as with a couple of others that seem to get people pretty heated. I am sure these ads will reach some that need to be reached. And let’s face it, the ones that want to be educated will do so regardless of these types of ads. It’s the ones that don’t look thoroughly for answers that will “go with the flow” on this ad campaign.
Alexis
November 21, 2011 at 8:31 pmGenerally I like to stay out of these arguments too. (Life is too short to get into a flame war on the Internet right?). I just started reading up on what was going on in Milwaukee and I got really sad about it. I knew everybody would be on the “ad=bad” side and I wanted to share a different view.
Thanks for visiting:)
Laura
November 26, 2011 at 11:05 pmMy thing is this: why would anyone want to engage in activities that might lead to their child’s death? We didn’t co-sleep as a general rule because every doctor, nurse, and midwife we encountered discouraged it. “Back to sleep.” There are a number of effective parenting strategies out there, and I’m not here to say one is better over another, but if death is the side effect of a particular strategy, I’m not going to do it. And as for everyone else, I guess that’s their decision, but I can’t understand it.
Alexis
November 28, 2011 at 2:38 pmSIDS is really rare (unless you live in Milwaukee in which case it’s frighteningly common) so I hate to write about it in panic inducing terms. I figure there are enough people out there trying to panic Moms. But you’re right, it does carry some risk and it’s very un-PC to talk about it. We actually tried (in desperation) a few times and I was so nervous that even when he fell asleep I had to stay awake to maintain my “safety vigil.”
Amanda
December 28, 2011 at 1:59 pmI hate to start a debate, but people engage in activities that might lead to their child’s death everyday. You have a CAR seat, don’t you?
Alexis
January 3, 2012 at 8:20 pmNo. I live in Vermont where horse and buggies are pretty standard. Usually we tie our baby to a haybale in the back.
Nobody is suggesting that you can 100% safety proof your child’s life. But if a certain group is consistently making unsafe choices that results in a shockingly high infant mortality rate, I think it’s reasonable to take steps to try to modify the unsafe behavior.
Matt
December 30, 2011 at 4:53 pm“People engage in activities that might lead to their child’s death everyday. You have a CAR seat, don’t you?” So true. Cars = death to babies. I don’t even take my precious outside of our carefully climate controlled apartment. You have heard of AIR POLLUTION haven’t you??
PS That ad strikes me as pretty smart. We do all kinds of paternalistic things in this country to try to save people from themselves. Alicia’s comment illustrates a very common mistake – assuming that educating people about something means they’ll make the right decision about it. I know, NO ONE knew nearly zero savings and subprime borrowing was a bad idea.
Kelsey
November 25, 2012 at 11:23 pmI’m a little late to the party here, but I’m glad I found this post and someone with a similar view point on this issue. As a new mom and a public health professional, I must first say THANK YOU for this post! Bravo for trying to get others to see this ad campaign wasn’t just another place to wage a co-sleeping/attachment parenting battle…we should instead be discussing the larger, life-threatening issue of how to increase funding and access for pre- and post-natal care and education, along with even larger issues like creating more economic opportunities and increasing access to all healthcare to save the families of Milwaukee from the tragedy of SIDS (and many other issues, I’m sure.)
This ad simply represents a cash-strapped public health department doing their best with the resources they were given. And while I agree that the ad was successful because it was memorable and caused a lot of discussion, I’d argue that it wasn’t successful with the target audience because they likely aren’t trolling the parenting blogosphere. And here is where I agree with everyone who takes issue with the fear tactic of this ad; personally, I’d prefer to see a positive ad (a smiley baby in a crib with happy mom looking on, preferably young and African-American) to encourage people to call in for assistance in getting a crib. (Kudos to them for having money for that program!) Because when crib companies sell us their expensive products, they do it with a smiley new baby and mom, each with a happy glow, and we gladly shell out hundreds of bucks – why shouldn’t public health use the same techniques to give away stuff FOR FREE!?
Thanks for the thoughtful post!
Alexis
November 26, 2012 at 1:47 pmThanks Kelsey,
I agree with your your point about happy babies in cribs. And really there IS no more powerful word in marketing than FREE – so that would have worked well too.
And to be fair, in hindsight, when I wrote this I was feeling grumpy about all the “how dare they” attachment parents out there because sometimes I feel that “we” by which I mean “people with money to spend on baby things” forget that not everybody is as lucky.
Thanks for your kind comment!
MomOf5andCounting
August 23, 2013 at 10:03 pmOk so I am really late in entering this conversation. I am on the other end of the co-sleeping debate. I will state that proudly. When my youngest son was born in 2005 my family practitioner said that it was the safest for baby sleeping. I had my daughter in 2008 and due to difficulties in my pregnancy she was born via C-section 5 weeks early. My doctor at this hospital (different hospital because I needed to be near a blood bank) their policy was no co-sleeping. Since we both had an extended stay in the hospital I couldn’t do what came natural to me. (oh and let me point out here that my son was almost 10 lbs at birth and my daughter was 8.5 lbs even at 5 weeks early.) She co-slept with us for probably the first 2 months before she went into the crib. My doctor that I had for my sons birth was our primary care doctor and she still said it was the safest. But the doctor where my daughter was born said it wasn’t. My point is that not all doctors agree on things, doesn’t make one right or one wrong just different opinions. And I would like to say that I loved this article even though I disagree with it because it is well written and gives your take on it without dissing the people with different opinions. This is a site I would enjoy coming back to for advice or even a different take on touchy subjects.
Alexis
August 26, 2013 at 12:26 pmThank you for your respectful disagreement 🙂 No seriously, that’s the goal for all of us right? To be able to share knowledge and experience, even if we’re not on the same page, in a way where we all come out ahead, right?
As for safe co-sleeping, what I’ve learned in my considerable experience with this blog is that it totally can be done safely. The AAP recommendation really comes down the fact that many many people make unsafe choices. That co-sleeping is not, innately, unsafe. But people’s choices are. Far too often.
If you’re interested in reading more I highly recommend Sleeping With Your Baby by McKenna. He’s the top researcher on the subject and very pro co-sleeping. His book is the best, most detailed overview of safe co-sleeping I’ve found. It’s a great resource to share with friends who might be interested in co-sleeping but are worried about safety stuff too.
Cheers!
Emily
March 20, 2016 at 2:08 pmJust wanted to let you know that, according to James McKenna, there is a very strong negative association with co-sleeping and SIDS (meaning that it is likely co-sleeping actually prevents SIDS). SIDS and suffocation are two different causes of death.
Alexis Dubief
March 22, 2016 at 11:12 amI know this is McKenna’s opinion, but currently the preponderance of the scientific evidence suggests the opposite: co-sleeping increases the risk of SIDS. It is a fair argument to say that the nature of the bedding has not been effectively studied, that is to say, is it possible that safe co-sleeping (ex following McKenna’s suggestions) leads to a a reduction in the incidence of SIDS. The answer is -we don’t know. What we DO know today is that more babies die co-sleeping than not. I’ll also say that I overwhelmingly see unsafe co-sleeping all the time. Like ALL the time. So these two factors (unsafe practices and lack of strong evidence) lead me to feel that no – it’s not a good idea.